Provider Demographics
NPI:1518962471
Name:ATKINS, STEWART P (PT)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:P
Last Name:ATKINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 15TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-3393
Mailing Address - Country:US
Mailing Address - Phone:205-758-0053
Mailing Address - Fax:205-758-0390
Practice Address - Street 1:1110 15TH ST
Practice Address - Street 2:STE C
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3393
Practice Address - Country:US
Practice Address - Phone:205-758-0053
Practice Address - Fax:205-758-0390
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3590225100000X
ALPTH2884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51505241Medicaid
MS04323710Medicaid
AL51505241OtherBCBS OF AL